Thesis Proposal Doctor General Practitioner in Nepal Kathmandu – Free Word Template Download with AI

This thesis proposal investigates the critical gap in primary healthcare delivery within Nepal's capital city, Kathmandu, with a specific focus on optimizing the role and deployment of Doctor General Practitioners (DGPs). Despite Nepal's National Health Policy 2019 emphasizing primary healthcare as the cornerstone of universal health coverage, Kathmandu faces severe overcrowding in tertiary facilities while underserved urban communities lack accessible first-contact care. This research aims to analyze current DGP utilization, identify systemic barriers within Kathmandu Municipality, and propose a scalable model for integrating DGPs into the public health infrastructure. Through mixed-methods research involving surveys of 150 patients, 30 healthcare providers (including DGPs), and key informant interviews with Kathmandu Metropolitan City (KMC) officials, this study will generate evidence to support policy reforms. The findings are expected to directly inform Nepal's Ministry of Health on strategies to strengthen primary care access in urban centers like Kathmandu, ultimately improving health outcomes for its densely populated residents.

Nepal's healthcare system, particularly in the rapidly urbanizing metropolis of Kathmandu, grapples with a profound shortage of first-line healthcare providers. Kathmandu, home to over 1.5 million people and experiencing explosive population growth, exhibits a stark disparity: while tertiary hospitals like Bir Hospital are perpetually overwhelmed with patients seeking basic care due to the scarcity of accessible primary points of contact, numerous neighborhoods lack even rudimentary clinics staffed by a Doctor General Practitioner (DGP). The World Health Organization (WHO) recommends a minimum of 23 physicians per 10,000 population for effective primary care; Nepal’s national ratio hovers around 0.3 per 10,000, with Kathmandu's urban areas facing an even more acute deficit. This crisis results in delayed diagnoses, increased out-of-pocket expenditures for citizens seeking care at distant hospitals (often traveling hours), and a strain on emergency services handling preventable conditions. A Doctor General Practitioner – defined as a physician trained to provide comprehensive, continuous, and coordinated primary care across all ages and conditions within the community setting – is not merely desirable but essential for Kathmandu’s health system resilience. This thesis proposal directly addresses the urgent need to establish, support, and effectively deploy DGPs as the foundational pillar of Kathmandu's primary healthcare network.

The current primary healthcare landscape in Nepal Kathmandu is characterized by fragmented services, over-reliance on specialized tertiary care for routine issues, and a critical shortage of trained DGPs operating within community clinics across the municipality. This leads to inefficient resource utilization, poor health outcomes (particularly for chronic conditions like diabetes and hypertension), high financial burden on households due to unnecessary hospital visits, and reduced trust in the formal healthcare system among vulnerable urban populations. The significance of this research is multi-fold: (1) It provides empirical evidence specific to Kathmandu's unique urban challenges; (2) It directly contributes to the implementation of Nepal's Health Sector Strategy 2015-2020 and subsequent policy documents which prioritize primary healthcare strengthening; (3) It offers a practical, contextually relevant model for scaling up DGP roles, potentially serving as a blueprint for other rapidly growing Nepalese cities. Resolving this gap is fundamental to achieving Nepal's Sustainable Development Goal 3 targets within the Kathmandu context.

Existing literature on Nepal's healthcare workforce highlights a systemic over-concentration of physicians in urban centers like Kathmandu, yet predominantly in tertiary hospitals, not primary care settings. Studies by the WHO (2021) and the Department of Health Services (DHS Nepal) consistently identify a severe deficit in community-based primary care providers. Research on DGP models globally emphasizes their role in reducing hospital admissions and improving population health, but adaptation to Nepal's specific socio-cultural, economic, and infrastructural realities is scarce. While pilot projects like the Rural Health Post program exist for basic health workers (e.g., Female Community Health Volunteers), they lack physician-level clinical capacity. A 2022 study by Tribhuvan University Medical Campus noted that Kathmandu's existing primary care centers often operate without a DGP, relying on nurses or untrained personnel for complex issues, leading to suboptimal care and patient dissatisfaction. This thesis directly bridges this gap by focusing *specifically* on the integration and effective function of the Doctor General Practitioner within the unique urban ecosystem of Nepal Kathmandu.

This study will employ a sequential mixed-methods approach to ensure comprehensive understanding. Phase 1: Quantitative analysis using structured surveys administered to patients attending public primary care clinics across three diverse Kathmandu districts (e.g., Lalitpur, Bhaktapur, and Kathmandu city wards) to assess access barriers, satisfaction levels related to DGP availability (or lack thereof), and health outcomes. Phase 2: Qualitative exploration through semi-structured interviews with 30 key stakeholders – including DGPs employed in private clinics or NGOs within Kathmandu, KMC health officials, representatives from the Department of Health Services (DHS), and community leaders – to identify systemic barriers (e.g., training gaps, remuneration structures, regulatory hurdles) and facilitators for DGP deployment. Phase 3: Analysis of existing KMC health facility data on patient flow and service utilization patterns related to primary care services. Data will be analyzed using SPSS for quantitative data and thematic analysis for qualitative transcripts. Ethical clearance will be obtained from the Institutional Review Board (IRB) of Kathmandu University School of Medical Sciences.

This research is expected to deliver a robust evidence base demonstrating the tangible impact of integrating DGPs into Kathmandu's primary healthcare framework. Key expected outcomes include: (1) A detailed mapping of current DGP distribution and service utilization patterns across Kathmandu; (2) Identification of specific, actionable policy recommendations for KMC and DHS regarding DGP training pathways, recruitment incentives, facility support, and integration within the existing health management system; (3) A validated model for scalable deployment of DGPs tailored to urban Nepalese contexts. This thesis will directly contribute to national health strategy implementation by providing Kathmandu Metropolitan City with a practical roadmap to enhance primary care accessibility, reduce healthcare inequities, and improve overall population health outcomes within Nepal's most populous city.

Addressing the critical shortage of Doctor General Practitioners in Nepal Kathmandu is not just an operational need; it is a fundamental requirement for building a resilient, equitable, and sustainable primary healthcare system capable of serving the city's burgeoning population. This Thesis Proposal lays the groundwork for essential research to catalyze this vital transformation.